Maladaptive personality traits, psychological morbidity and coping strategies in chronic central serous chorioretinopathy

Abstract

Purpose ‘Type A’ behavioural characteristics and psychosocial stress have traditionally been associated with chronic central serous chorioretinopathy (cCSC). However, a characteristical personality profile could not be identified in these patients and the presumed association with stress is subject to controversy, due to a lack of convincing studies using validated measuring instruments. In this study, we aimed to assess maladaptive personality traits, psychological morbidity and coping strategies in patients with cCSC, in order to identify potentially modifiable psychosocial aspects which could be used in support to current standard treatment. Methods A cross‐sectional study in a cohort of 86 patients with cCSC using validated questionnaires. Findings were compared to both Dutch population reference data and reference data from patients treated for Cushing's disease. Results Maladaptive personality traits were not more prevalent in patients with cCSC than in the general population, and psychological morbidity was not increased. Patients with cCSC were shown to make more use of passive coping, active coping and seeking social support. Interestingly, personality, psychological morbidity and coping characteristics of patients with cCSC were more comparable to features of patients treated for Cushing's disease than to population‐based data. Conclusion Maladaptive personality traits such as type A behavioural characteristics are not more prevalent in patients with cCSC. Patients with cCSC make more use of certain coping strategies, which could be addressed by psychosocial care to improve self‐management. Further research is needed establish whether the course of disease can be improved by altering coping and reducing ‘stress’.

Stress and vision-related quality of life in acute and chronic central serous chorioretinopathy

“…Thus, the result can get altered with the perspective of the patient. A study by van Haalen et al, agrees with our study finding suggesting that chronic CSC patient have many adaptive strategies and coping mechanisms to overcome stress and it is not necessarily the causative [28].…”

Hair cortisol concentrations in chronic central serous chorioretinopathy

“…), as well as in a psychological questionnaire survey ( n = 86, data presented elsewhere) (van Haalen et al. ). For the present study, exclusion criteria were excessive alcohol intake (>21 units/week), the use of corticosteroids (both systemic and local) or sleep medication prior to the development or during the time–course of cCSC and either night shift work or travelling from another time zone in the 6 weeks prior to evaluation.…”

Central serous chorioretinopathy: An update on risk factors, pathophysiology and imaging modalities

“…Further suspicion for the role of androgens in CSC comes from studies showing higher levels of urinary testosterone in patients with type A personalities, a potential risk factor for CSC (Zumoff et al 1984). However, the role of personality traits in CSC is still up for debate (van Haalen et al 2018a). Androgen receptors are present in the mammalian choroid and human RPE (Wickham et al 2000), and mRNA for 5-α reductase, the enzyme responsible for the conversion of testosterone to the more potent dihydrotestosterone has also been found (Rocha et al 2000).…”

“…Additionally, type A personality is a term that is not well-circumscribed and not often used in psychology nowadays (van Haalen et al 2018b). Further studies using validated personality questionnaires on personality traits have shown no link with maladaptive personality traits in CSC patients (van Haalen et al 2018a). Our experience from clinical practice does however suggest patients with CSC are often of above-average intelligence.…”